Community attitudes and Indigenous health disparities: evidence from Australia's Voice referendum

IF 7.6 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES The Lancet Regional Health: Western Pacific Pub Date : 2024-09-01 DOI:10.1016/j.lanwpc.2024.101154
{"title":"Community attitudes and Indigenous health disparities: evidence from Australia's Voice referendum","authors":"","doi":"10.1016/j.lanwpc.2024.101154","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Community attitudes influence health outcomes especially for racially diverse and minority groups exposed to the detrimental effects of racism and discrimination. Using the results from Australia's national referendum to establish an Aboriginal and Torres Strait Islander Voice to Parliament (‘the Voice’) as a proxy for attitudes to Indigenous Australians, this study examined health outcomes for Indigenous and non-Indigenous Australians according to levels of opposition to the Voice.</div></div><div><h3>Methods</h3><div>The regional share of votes against the Voice was linked to 2021 data from the Household, Income and Labour Dynamics in Australia survey, a large, national probability sample (n∽17,000) of Australian adults. Adjusting for regional-level confounders, we used logistic regression analyses to predict health outcomes, healthcare use, and risk-taking behaviours among Indigenous and non-Indigenous Australians for different levels (quartiles) of opposition to the Voice.</div></div><div><h3>Findings</h3><div>Greater opposition to the Voice was associated with widening Indigenous disparities in health, healthcare use, and health behaviours. Indigenous Australians living in regions with the highest opposition to the Voice (top quartile: <span><math><mrow><mo>≥</mo></mrow></math></span>72% community voting ‘No’) were more likely to report fair/poor health [OR 2.28 (95% CI 1.45–3.58)] and poor mental health [OR 2.24 (95% CI 1.48–3.39)], were less likely to have visited any healthcare provider [OR 0.52 (95% CI 0.36–0.75)], and were more likely to smoke [OR 4.21 (95% CI 2.78–6.38)] or engage in risky drinking [OR 2.66 (95% CI 1.60–4.43)] relative to non-Indigenous Australians.</div></div><div><h3>Interpretation</h3><div>Indigenous Australians living in communities with greater opposition to the Voice experience poorer health relative to non-Indigenous Australians. Disparities in health may be partially due to poorer healthcare access and increased risk-taking behaviours, which may be associated with racism. These findings align with discrimination-related stress processes and potentially reduced availability of culturally inclusive healthcare. Health and social policy should consider how broader societal level conditions shape Indigenous health disparities in Australia.</div></div><div><h3>Funding</h3><div>This work is supported by the <span>Australian Research Council</span> (project ID FT200100630), the <span>University of Melbourne Faculty Research</span> Grant, and the <span>National Health and Medical Research Council</span> of Australia Investigator Grant (project ID 1201937).</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":null,"pages":null},"PeriodicalIF":7.6000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"The Lancet Regional Health: Western Pacific","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666606524001482","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0

Abstract

Background

Community attitudes influence health outcomes especially for racially diverse and minority groups exposed to the detrimental effects of racism and discrimination. Using the results from Australia's national referendum to establish an Aboriginal and Torres Strait Islander Voice to Parliament (‘the Voice’) as a proxy for attitudes to Indigenous Australians, this study examined health outcomes for Indigenous and non-Indigenous Australians according to levels of opposition to the Voice.

Methods

The regional share of votes against the Voice was linked to 2021 data from the Household, Income and Labour Dynamics in Australia survey, a large, national probability sample (n∽17,000) of Australian adults. Adjusting for regional-level confounders, we used logistic regression analyses to predict health outcomes, healthcare use, and risk-taking behaviours among Indigenous and non-Indigenous Australians for different levels (quartiles) of opposition to the Voice.

Findings

Greater opposition to the Voice was associated with widening Indigenous disparities in health, healthcare use, and health behaviours. Indigenous Australians living in regions with the highest opposition to the Voice (top quartile: 72% community voting ‘No’) were more likely to report fair/poor health [OR 2.28 (95% CI 1.45–3.58)] and poor mental health [OR 2.24 (95% CI 1.48–3.39)], were less likely to have visited any healthcare provider [OR 0.52 (95% CI 0.36–0.75)], and were more likely to smoke [OR 4.21 (95% CI 2.78–6.38)] or engage in risky drinking [OR 2.66 (95% CI 1.60–4.43)] relative to non-Indigenous Australians.

Interpretation

Indigenous Australians living in communities with greater opposition to the Voice experience poorer health relative to non-Indigenous Australians. Disparities in health may be partially due to poorer healthcare access and increased risk-taking behaviours, which may be associated with racism. These findings align with discrimination-related stress processes and potentially reduced availability of culturally inclusive healthcare. Health and social policy should consider how broader societal level conditions shape Indigenous health disparities in Australia.

Funding

This work is supported by the Australian Research Council (project ID FT200100630), the University of Melbourne Faculty Research Grant, and the National Health and Medical Research Council of Australia Investigator Grant (project ID 1201937).
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
社区态度与土著人的健康差距:来自澳大利亚之声全民公决的证据
背景社区态度会影响健康结果,尤其是对受到种族主义和歧视有害影响的种族多样性和少数群体而言。本研究以澳大利亚关于在议会中设立土著居民和托雷斯海峡岛民之声("之声")的全国公民投票结果作为对澳大利亚土著居民态度的代表,根据反对 "之声 "的程度研究了澳大利亚土著居民和非土著居民的健康结果。在对地区层面的混杂因素进行调整后,我们使用逻辑回归分析预测了不同程度(四分位数)反对 "声音 "的土著和非土著澳大利亚人的健康结果、医疗保健使用情况和冒险行为。生活在 "声音 "反对率最高地区(最高四分位数:≥72%的社区投 "反对 "票)的土著澳大利亚人更有可能报告健康状况一般/较差[OR 2.28 (95% CI 1.45-3.58)]和精神健康状况较差[OR 2.24 (95% CI 1.48-3.39)],更不可能去看任何医疗机构[OR 0.52 (95% CI 0.与非土著澳大利亚人相比,他们更有可能吸烟[OR 4.21 (95% CI 2.78-6.38)]或酗酒[OR 2.66 (95% CI 1.60-4.43)]。健康差异的部分原因可能是医疗保健服务较差和冒险行为增多,这可能与种族主义有关。这些研究结果与与歧视有关的压力过程以及具有文化包容性的医疗保健服务可能减少的情况相吻合。健康和社会政策应考虑更广泛的社会层面条件如何影响澳大利亚土著人的健康差异。基金资助这项工作得到了澳大利亚研究理事会(项目编号:FT200100630)、墨尔本大学学院研究基金和澳大利亚国家健康与医学研究理事会研究员基金(项目编号:1201937)的支持。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
The Lancet Regional Health: Western Pacific
The Lancet Regional Health: Western Pacific Medicine-Pediatrics, Perinatology and Child Health
CiteScore
8.80
自引率
2.80%
发文量
305
审稿时长
11 weeks
期刊介绍: The Lancet Regional Health – Western Pacific, a gold open access journal, is an integral part of The Lancet's global initiative advocating for healthcare quality and access worldwide. It aims to advance clinical practice and health policy in the Western Pacific region, contributing to enhanced health outcomes. The journal publishes high-quality original research shedding light on clinical practice and health policy in the region. It also includes reviews, commentaries, and opinion pieces covering diverse regional health topics, such as infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, aging health, mental health, the health workforce and systems, and health policy.
期刊最新文献
A contemporary analysis of the Australian clinical and genetic landscape of spinal muscular atrophy: a registry based study A complex intervention to reduce antibiotic prescribing in rural China: a cluster randomised controlled trial Impact of time to antibiotics on clinical outcome in paediatric febrile neutropenia: a target trial emulation of 1685 episodes Why I decide to leave South Korea healthcare system Towards an agenda of action and research for making health systems responsive to the needs of people with disabilities
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1